FDA Adverse Event Injury Summary report: N

CARPENTIER-EDWARDS PERIMOUNT RSR PERICARDIAL BIOPROSTHESIS

MDR report key: 1212071 · Received October 23, 2008

Report

Report Number
6000002-2008-09033
Event Type
Injury
Date Received
October 23, 2008
Date of Event
September 17, 2008
Report Date
October 6, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
LWR
PMA / PMN Number
P860057/S001
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS EXPLANTED APPROXIMATELY AFTER IMPLANT DURATION OF 104 MONTHS, DUE TO UNK REASONS. NO FURTHER DETAILS WERE PROVIDED. INFO LEARNED FROM IMPLANT PT REGISTRY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PERIMOUNT RSR PERICARDIAL BIOPROSTHESIS REPLACEMENT HEART VALVE LWR EDWARDS LIFESCIENCES 2800 9M1683

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention